The Bill does not meet its aim of reflecting ‘biological reality’. Biological sex is not a clean binary. It is a complex, multi-dimensional set of characteristics encompassing chromosomal, gonadal, hormonal, and anatomical variation. Intersex traits are a naturally occurring biological phenomenon, estimated at 1.7% of the population. As written, the Bill would impose legal categories on people which do not reflect their biological reality, identity or lived experience.
The increased rates of depression, anxiety, self-harm, and suicidality experienced by LGBTIQ+ people are explained in significant part by societal responses - by stigma, discrimination, and exclusion. This Bill will add to that stigma and cause further harm to this vulnerable group. LGBTIQ+ young people are at an elevated risk of developing a mental health condition and attempting suicide. Different cultures also often have a different view of gender. Concepts such as takatāpui, fa'afafine, and fakaleiti are long standing and culturally embedded. This Bill will further stigmatise and isolate groups jeopardising their ability to get health care in a way that is equitable. The Bill may also have a negative impact on doctors’ ability to provide appropriate care, as sex, gender identity, and lived experience may all be relevant variables that will impact on clinical decision-making.
Imposing a universal statutory definition across all legislation will create numerous unintended consequences across the health system. The Bill defines 'woman' as 'an adult human biological female' but 'female' as simply 'a human biological female' with no age qualifier. Any legislation usings 'woman' rather than 'female' would exclude biological females below the adult threshold. A key example of where this will cause harm is in relation to the Contraception, Sterilisation and Abortion Act 2020, which uses the term 'woman' to describe who may access abortion services. Under the current Bill, biological females under the age of 20 will no longer be able to access these services. The Bill will prevent trans, and intersex people from being able to access abortion services for the same definitional reasons. Females under 20 may no longer be eligible to apply to the court for a declaration of paternity; and the partner or spouse of a female under 20 may be unable to access parental leave, because the relevant legislation requires a certificate confirming a 'woman' is pregnant.
The majority of medical colleges in Aotearoa supported the CMC submission. RACS strongly opposes this Bill on the grounds that it fails to reflect scientific complexity, will have a negative impact on specific groups of people, and will result in unintended consequences that may cause harm to patients.
Read submission (PDF 209.84KB).